Rhabdomyolysis in the Setting of Induced Hypothyroidism and Statin Therapy: A Case Report

Jbara, Yaser; Bricker, Dean

doi:10.1159/000371548

Cited by 16 publications

(7 citation statements)

References 14 publications

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“…[ 12 ] Hypothyroid state in patients on statin therapy can also increase the risk of rhabdomyolysis. [ 13 ] We considered statin-induced rhabdomyolysis to be precipitated by either uncontrolled hypothyroidism or ticagrelor. In addition to increasing the dose of levothyroxine, we stopped both rosuvastatin and ticagrelor therapies.…”

Section: Discussionmentioning

confidence: 99%

Post-COVID multisystem inflammatory syndrome–adult (MIS-A) presenting with rhabdomyolysis and AKI

Mazumder¹,

Narula²,

Gulati³

et al. 2022

Indian J Nephrol

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Multisystem inflammatory syndrome is a rarely reported post-COVID (coronavirus disease) phenomenon in adults. Our understanding of the multisystem inflammatory syndrome– adult (MIS-A) is based on multiple case reports that have demonstrated heterogeneous clinical presentations and treatment options. Rhabdomyolysis is an unusual presentation of MIS-A. We report the case of a 61-year-old man who presented with rhabdomyolysis with acute kidney injury (AKI), acute inflammatory demyelinating polyneuropathy (AIDP), myocarditis, disseminated intravascular coagulation, and minimal respiratory symptoms. The patient was found to have post-COVID inflammatory syndrome and recovered with supportive treatment and intravenous immunoglobulin (2 g/kg over 5 days). COVID-19 (coronavirus disease 2019) antibody positivity played a significant role in making the diagnosis of MIS-A and in providing prompt treatment.

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Section: Discussionmentioning

confidence: 99%

Post-COVID multisystem inflammatory syndrome–adult (MIS-A) presenting with rhabdomyolysis and AKI

Mazumder¹,

Narula²,

Gulati³

et al. 2022

Indian J Nephrol

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“…Acute renal failure is among the most common complications, seen in up to 50% of patients with rhabdomyolysis 6 . While CK elevations can occur with untreated hypothyroidism, a progression of overt rhabdomyolysis because of hypothyroidism is rarely described in the literature 7–12 …”

Section: Discussionmentioning

confidence: 99%

“…6 While CK elevations can occur with untreated hypothyroidism, a progression of overt rhabdomyolysis because of hypothyroidism is rarely described in the literature. [7][8][9][10][11][12] The pathophysiology behind hypothyroidism-inducing rhabdomyolysis is complex and multifactorial. It is thought to be primarily due to impaired glycogenolysis and mitochondrial oxidation.…”

Section: Casementioning

confidence: 99%

Acute Flaccid Paralysis in an 11-Year-Old

Schwartz¹,

Bishop²,

Le³

et al. 2018

Pediatr Emer Care

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Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and subsequent release of intracellular components into the systemic circulation. We report a case of rhabdomyolysis causing acute paralysis from underlying and unrecognized hypothyroidism in an 11-year-old girl. To date, publications of rhabdomyolysis secondary to hypothyroidism have been limited, especially in the pediatric population. Early intervention with intravenous fluids and levothyroxine led to resolution of our patient's symptoms and is overall important in preventing the serious sequela of rhabdomyolysis including renal failure, cardiac dysrhythmias, compartment syndrome, and disseminated intravascular coagulation.

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“…Neither of the previously reported cases resulted in overt rhabdomyolysis or the need for treatment of acute kidney injury. Possible explanations for how hypothyroidism might enhance statin myopathy include decreased clearance of CK or decreased drug catabolism, resulting in higher serum statin levels [ 117 ].…”

Section: Statin Treatment In Postmenopausal Womenmentioning

confidence: 99%

Cardiovascular Risk and Statin Therapy Considerations in Women

et al. 2020

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Despite major progress in the prevention and treatment of cardiovascular diseases, women remain an underdiagnosed and insufficiently treated group, with higher hospitalization and death rates compared to men. Obesity, more frequently encountered in women, raises the risk of metabolic syndrome and cardiovascular diseases as women age. There are some differences based on sex regarding the screening, diagnosis, and treatment of dyslipidemia, as it has been observed that women are less frequently prescribed statins and, when they are, they receive lower doses, even after myocardial infarction or coronary revascularization. Real-life data show that, compared to men, women are at higher risk of non-adherence to statin treatment and are more predisposed to discontinue treatment because of side effects. Statin metabolism has some particularities in women, due to a lower glomerular filtration rate, higher body fat percentage, and overall faster statin metabolism. In women of fertile age, before initiating statin treatment, contraception methods should be discussed because statins may have teratogenic effects. Older women have a higher likelihood of polypharmacy, with greater potential for drug interactions when prescribing a statin.

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Rhabdomyolysis in the Setting of Induced Hypothyroidism and Statin Therapy: A Case Report

Cited by 16 publications

References 14 publications

Post-COVID multisystem inflammatory syndrome–adult (MIS-A) presenting with rhabdomyolysis and AKI

Post-COVID multisystem inflammatory syndrome–adult (MIS-A) presenting with rhabdomyolysis and AKI

Acute Flaccid Paralysis in an 11-Year-Old

Cardiovascular Risk and Statin Therapy Considerations in Women

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